Remember 2007?  That was the year Avastin was going to set the world on fire.  There was improved survival success in colon cancer, then lung cancer.  Avastin was on a tear.

Improved survival is an easy sell to the FDA.  The survival advantage wasn't huge, but it was statistically reproducible, and so the benefit of helping people with advanced cancer live longer made this new treatment attractive.

I was ready to pass on blogging about WSJ's review of UnitedHealthcare's study of oncology prescribing practices until I saw this statistic: 31% of colon cancer patients are getting Avastin in the postop setting.  This is clearly outside the lines of conventional treatment, and turns on its ear the concept that doctors, left to their own devices, will provide appropriate care.

Hormone replacement is a difficult and emotional subject, and researchers have made it more complex with findings that women who took hormone replacement were about 1/3 less likely to develop colon cancer.

This was a large observational study, meaning they weren't specifically looking to find such an association. Still, I always look at the magnitude of benefit and the statistics. As a friend once said, I like to see the p-value.

Podcast file: 

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1-26-10.mp3

How aggressive should the chemo for rectal cancer be? A newly published study doesn't make the question any easier.

Publishing in Lancet Oncology, a British group treated patients with a combination of Xeloda and oxaliplatin initially, then Xeloda and radiation, then surgery.

In the 105 patients studied with poor risk disease, recurrences were rare at five years.

How aggressive should the chemo for rectal cancer be? A newly published study doesn't make the question any easier.

Publishing in Lancet Oncology, a British group treated patients with a combination of Xeloda and oxaliplatin initially, then Xeloda and radiation, then surgery.

In the 105 patients studied with poor risk disease, recurrences were rare at five years.

Though the study was a Phase II clinical trial, the medicine KRX-0401 appeared to have success in a tough segment of oncology: metastatic colon cancer.

We haven't had a new drug in colon cancer since Erbitux and Vectibix in 2006. Keryx appears poised to open a Phase III clinical trial, and positive movement on their share price today means they'll probably have the dough to do it (otherwise get bought).

It's pretty rare for a phase II clinical trial to have positive survival results. Either this drug is poised to become the next blockbuster, or it's the flash in the pan of the week.

Podcast file: 

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1-23-10.mp3

This time, researchers found that low circulating Vitamin D levels were linked to colon cancer.

The article on ABCNews.com was at least balanced, stating that the current results are "inconclusive" and that a large prospective study will have more clinical relevance once completed.

http://abcnews.go.com/Health/WellnessNews/low-vitamin-levels-linked-colo...

This time, researchers found that low circulating Vitamin D levels were linked to colon cancer.

The article on ABCNews.com was at least balanced, stating that the current results are "inconclusive" and that a large prospective study will have more clinical relevance once completed.

http://abcnews.go.com/Health/WellnessNews/low-vitamin-levels-linked-colon-cancer-study-finds/story?id=9636657

Podcast file: 

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1-21-10a.mp3

Interesting news about two new drugs in MS and a promising new treatment in colon cancer, reviewed for your listening information.

The findings were presented today at the ASCO GI malignancies symposium that disease free survival was improved with oral Xeloda versus conventional intravenous 5FU in patients with early colon cancer. Dr. Daniel Haller from University of Pennsylvania presented the data; he has been working on colon cancer research protocols for many years.

The media perhaps overreacted to the news: headlines such as